Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 174989-1 | NY |
NPI | 1043221450 |
---|---|
Provider Name | Michael Bernstein |
First Address | Brooklyn, NY 11234-6901 |
Second Address | Brooklyn, NY 11235-7745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01326916 | (05) | NY |
F27469 | (02) | NY |